Stephanie Marie Dickerson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.183075 Issued in OH

Practice address

115 S Wooster Ave
Dover, OH 44622-1944

Phone

(833) 510-4357

NPI assigned

May 13, 2022

Last updated

Aug 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Caudill & Van Voorhis, Inc.

  dba Advanced Spinal Care & Rehabilitation

  • Chiropractor
  • Cambridge, OH
  • NPI 1659551117
  NPD
• Spero Health of Ohio, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Zanesville, OH
  • NPI 1346748563
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1851038608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "513-873-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S WOOSTER AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446221944",
            "telephone_number": "833-510-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 Southgate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "OH",
            "postal_code": "437253024",
            "country_code": "US",
            "telephone_number": "740-781-0320 x51198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.183075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101M00000X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra M. Dehoust, CT
• Edgar Rodriguez Delacruz, M.D.
• Lori Denham
• Zachary Ryan Denham, MD
• Timothy Paul Desiato, M.D.
• Discount Drug Mart Inc (Discount Drug Mart)
• Andrea Lynn Dominick, LPCC-S, LICDC
• Brittany Jane Douglas
• Sara Ashley Douglas
• Dover City Schools

• Addiction (Substance Use Disorder) Counselor in Dover, OH
• Providers in Dover, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.